BY ANNE NUGENT GUIGNON, RDH, MPH, CSP
It is a huge honor and responsibility to help fellow practitioners figure out how to prevent, combat, or resolve the nagging aches and pains. According to Mark Hartley, the editor of RDH, thousands of hygienists have been spared unnecessary pain and have been able to have longer and more productive careers.
Thanks to Mark's vision and support, RDH magazine will continue to be a leader in the fight for workplace wellness, which should be a right, not a privilege. Through the years I've received many communications from hygienists and students about how to combat their physical pain and discomfort that is directly related to clinical practice. Today I received an email from a young man whose girlfriend is a hygienist. She is lucky to have someone in her life who understands that pain is not the price we should pay for doing a good day's work.
He wrote, "I'm contacting you on behalf of my girlfriend who is a dental hygienist. She comes home every day in tears because of her back pain. She's trying yoga and physical therapy, but I thought perhaps a back brace would also help. I've read some Amazon reviews from hygienists on this subject, and I thought I'd buy her one. Do you recommend these at all? I got your email from the article you wrote in rdhmag.com. Thanks!"
His name is Jeff, and I'm not sure which article he read in RDH. The physical issues associated with dental hygiene are extensive and serious. I've published hundreds of articles over the last 16 1/2 years, so it's nice to hear that information is getting out.
Jeff works in the computer world, and how we practice dental hygiene is totally analogous to BIOS in his world. Any computer is only so good as the basic in-and-out system. The human body is no different. If we subject ourselves to an impossible working environment day after day, we're going to crash, and it sounds like his girlfriend is headed down that pathway right now.
Yoga is a great intervention/prevention modality, but physical therapy tells me she is getting hurt. Quite honestly, a back brace is like a bandage on a bleeding carotid artery.
Many hygienists do not want spend their own money to really solve the problems, but it starts with how we work. With out the proper equipment, we work with awkward, static postures performing forceful, repetitive procedures hour after hour. And in today's competitive job environment it is not unusual for a hygienist to work straight though an eight- or 10-hour day just to keep everyone in the office happy.
He did not mention if she is wearing magnification loupes, a headlight, or using a saddle stool. All are excellent tools that work well synergistically to counteract horrible postures. Even if she has loupes, they may not be properly fitted or constructed. Headlights eliminate having to constantly reposition the overhead light, which is very hard on both the neck and shoulder. The right kind of saddle stool will allow her to work using a sit/stand positioning and work closer to the patient, reducing harmful shoulder postures.
How many hours does she work? Does she work without breaks? Does she have enough time for each patient? What is the room layout? Does she work in a room with rear delivery, a very popular configuration that is forces a solo clinician to twist and turn all day long.
How complex are the patients? Is her day full of patients who haven't been seen in years? Does she have a decent power driven scaler and enough sharp hand instruments?
Does she have any pre-existing medical conditions, a history of a back injury? Does she have any sports injuries? Did she work as a dental assistant prior to becoming a dental hygienist?
While it is hard to control a lot of the office dynamics, it is possible for every clinician to get loupes, light, and a saddle. And many of us own our own hand and power scalers. The more we take charge of our own environment and health, the better off our health will be.
When I started getting injured 35 years ago, I was frantic to find a way to be more comfortable and quit hurting. People laughed at me when I started buying my own equipment. I even toted equipment from location to location, because I felt better and I did not have to put up with equipment that did not work for me.
Many hygienists feel it is a doctor's responsibility to provide a safe working environment, and I couldn't agree more. But the reality is no one will ever pay you enough to get hurt. A perfect example is the current concern for long-term health issues sustained from athletic injuries. I can't force doctors to provide a safe working space, but I can sound the alarm bells and encourage hygienists to protect themselves, even if it means spending their own money.
My colleague Cindy Purdy and I conducted a large study on workplace-related injuries in dental hygiene several years ago. Unfortunately, over 50% of all subjects reported one or more WRMSDs. Many cut back their work hours either temporarily or permanently. What ever perceived dollars they may have saved by not getting their own equipment vanished into a black hole of lost wages and mounting medical expenses. Some were even forced to retire.
I'm not trying to paint a bleak picture, but we are witnessing the dirty little secret that many in our profession are getting hurt.
Do I think a back brace will help? Possibly, but the real question is why is she having so much pain? Jeff has a good reason to be concerned. Coming home in tears is not right. It is not right for her, and it will also impact on their relationship.
I've been a clinical dental hygienist since 1971 and practiced full time for over 37 years and part time since then. I've seen way too many of my colleagues fall apart because of workplace-related musculoskeletal disorders. Her tears and pain are genuine, and she is lucky to have him in her life.
Jeff is obviously a kind-hearted soul and concerned about her welfare. I hope he encourages her to step back and take a serious look at why she is in so much pain and make a plan on how to reverse her current situation. Her professional comfort zone is in severe jeopardy, and Jeff can be the steadfast voice of reason if she thinks she can't afford to take some of these suggestions. RDH
ANNE NUGENT GUIGNON, RDH, MPH, CSP, provides popular programs, including topics on biofilms, power driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 ADHA Irene Newman Award, Anne has practiced clinical dental hygiene in Houston since 1971, and can be contacted at [email protected].